Assessing the efficacy of a community-based COVID-19 program with vulnerable and underserved Latino communities

Latinos with limited English proficiency (LEP) faced disproportionate barriers to COVID-19 testing and prevention in the United States. The present study evaluates the RAPID model, implemented by community health workers (CHWs) who have established ties with Latinos with LEP, aimed at expanding access to culturally and linguistically congruent COVID-19 testing and other services. Guided by the cross-sector alignment theory of change, we assessed the impact of the RAPID model on behaviors, knowledge, and beliefs related to COVID-19, as well as on perceived challenges and trust in information sources. Using a quasi-experimental design, survey data analyzed 410 Latino adults who received free COVID-19 testing at either RAPID events or traditional sites. Participants were matched using propensity score matching to control for differences in sociodemographic characteristics. Regression analyses revealed that RAPID participants reported significantly higher knowledge of COVID-19 mitigating behaviors and increased trust in official sources compared to matched controls. Interestingly, Spanish-speaking RAPID participants demonstrated significantly lower engagement in COVID-19 risk behaviors and higher knowledge than their Spanish-speaking control counterparts, suggesting a moderating effect of language. Findings support the critical role of CHWs in reducing health disparities, particularly among linguistically underserved populations. The study underscores the value of cross-sector collaboration and CHW integration in public health systems and highlights the need for sustainable funding and support for CHWs to maintain community readiness in future health crises.